NON-CONFORMANCE REPORT (NCR)

PART A DETAILS
NCR NO: HSSI(PDMO)/CVIA(P1)-0038/22 PACKAGE/LOCATION: CVIA PHASE 1
ISSUED TO: MTD CONSTRUCTION NAME OF IDENTIFIER: DESMOND DATE ISSUED: 15 AUGUST 2022
SDN BHD PEREIRA
REFERENCE DOCUMENTS:
1. OSHA 1994
2. FMA 1967
3. EQA 1974
PART B NON-CONFORMITY STATEMENT
1. Use of household electric cables and plugs.

Reply Due Date: 19 August 2022 Attachment(s): Record Photo

Estimated Non-Conformance Value: Issued by: Confirmed by: Received by:

RM ______________
PD HSSI Contractor
PART C PROPOSED CORRECTIVE ACTION (to be completed by the Contractor)
CAUSE OF NON-CONFORMITY

IMMEDIATE ACTION

Target Date for Completion:

LONG TERM CORRECTIVE ACTION

Target Date for Completion:

Action by: Agreed by: Verified by:

Contractor Identifier PD HSSI

PART D VERIFICATION OF CORRECTIVE ACTION
FOLLOW-UP REPORT

NCR Closed Out? Complied by: Verified by: Approved by:

YES - Date:
NO - Next completion date:
Contractor Identifier PD HSSI
 PICTURE ATTACHMENTS

Four Building - Use of household electric cables and plugs.

Pipe Jacking – Use of household electric cables and plugs.